California ranks 9th overall when it comes to meeting the long-term care needs of older residents, but AARP warns much more must be done, at an accelerated pace, to improve the state’s health care system around prevention & treatment, affordability & access in Adult Day Resource Center functions, nursing home costs/quality-of-life, quality-of-care in the LTSS system, and support for family caregivers.

California’s ranking is part of a comprehensive state-by-state Scorecard from AARP with support from the nation’s leading organizations behind quality long-term care, The Commonwealth Fund and SCAN Foundation.

Raising Expectations 2014: A State Scorecard on Long-Term Services and Supports for Older Adults, People with Physical Disabilities, and Family Caregivers – an update of the inaugural 2011 Scorecard – ranks each state overall and within 26 performance indicators along five key dimensions: affordability & access, choice of setting and provider; quality-of-life & quality-of-care, support for family caregivers, and effective transitions. New indicators this year include length of stay in nursing homes and use of anti-psychotic drugs by nursing homes.

“The vast majority of older Californians want to live independently, at home, as they age – most with the help of unpaid family caregivers,” says Blanca Castro, AARP’s California advocacy director.

“Even facing tight budgets following the Great Recession, California is making some progress to help our older residents achieve that goal. However, this Scorecard shows we have much more to do – and we don’t have time to stand idle.”

Today, unpaid family caregivers provide the bulk of care for older Californians, in part because the cost of long-term care remains prohibitive for most middle-income families. In California, more than 4 million residents help their aging parents, spouses or other loved ones stay at home by providing assistance with bathing and dressing, transportation, finances, complex medical tasks like wound care, injections, and more. The annual labor value of this unpaid care totals about $47 billion.

“When it comes to helping older Californians live in the setting of their choice, this silent army of family caregivers assumes the lion’s share of responsibility,” explains Castro. “Many juggle full-time jobs with their caregiving duties; others provide 24/7 care for their loved ones. With every task they undertake, these family caregivers save the state money by keeping their loved ones out of costly nursing homes, which are most often paid for by Medi-Cal. They therefore deserve some basic support from the state.”

According to the state Scorecard, a number of family caregivers (55%) face a degree of stress and worry.

That’s why AARP in California has sponsored the California Care Act of 2014 (AB 1744). This critical legislation would create a Blue Ribbon Caregiver Task Force to help California better understand and support the work that family caregivers do and the contributions they make.

The Blue Ribbon Panel will:

Compile an inventory of the resources currently available to support family caregivers as they help seniors live independently at home.

Identify further policies and resource options that will fill any gaps that are identified.

Provide a recommendation to the state legislature on how to improve support for family caregivers in California.

“This Scorecard gives us a snapshot of how well California serves our older residents, those with disabilities, and family caregivers – and shows us where we must sharpen our focus to better assist hardworking Californians,” concludes Castro. “Now is the time for policymakers to act.”

Of the 26 Scorecard indicators, 13 may be improved through state policy changes, pointing to the importance of AARP’s multi-state advocacy campaign, launched this year, to help older Americans live independently, at home, and the family caregivers that support them. Currently, 42 states are advocating as part of the campaign, including California.

The Scorecard finds that “in just 12 years, the leading edge of the Baby Boom Generation will enter its 80s, placing new demands on a still imperfect long-term care system. Further, this generation will have far fewer potential family caregivers to provide unpaid help.”

Long-term care (also called long-term services and supports) is a diverse set of services designed to help older people and those with disabilities; services can be provided in a person’s home, in a community setting such as an adult day center, or in a group residential facility like a nursing home.

The full state Scorecard, along with an interactive map of state rankings and information, is available at www.longtermscorecard.org.